101 Clinical Cases in Emergency Room
101 Clinical Cases in Emergency Room
Second Edition
Editor
Badar M Zaheer MD
Board Certified in Emergency Medicine and Family Medicine Associate Professor UIC College of Medicine Chicago, Illinois, USA
Jaypee Brothers Medical Publishers (P) Ltd
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101 Clinical Cases in Emergency Room
First Edition: 2014
Second Edition: 2020
9789352703333
Printed at
The memory of my father Dr Abdul Hafeez who used to say, “be an asset to your community, society, and nation at large and make a difference in somebody's life.” I'll consider myself fortunate to follow in your footsteps.
Just as the field of emergency medicine has evolved over the last several years, we have sought to evolve and enhance our understanding of this exciting field with the second edition of this book. We have worked hard to update you with the most common emergencies and the most up-to-date methods to deal with those emergencies.
In this edition, we have laid out the management of critical emergencies such as STEMI, non-STEMI, and “unstable angina”. With the rapid growth of STEMI centers, the protocols and guidelines are very precise allowing emergency providers to save more lives. We have also included the new classification guidelines of “myocardial infarction” with an explanation of the different types of MI. Additionally, stroke guidelines are clearer than ever before, and similarly have allowed improved patient outcomes. Finally, we know that sepsis is the leading cause of mortality in the developing world. Thus, we have sought in this book to increase understanding of sepsis management and the rule of 1-1-1. Our hope with this second edition is that you learn to manage these complex emergencies that we have worked to simplify.
We know that students learn best with visual aids, thus we have gone to great lengths to add visual diagrams, tables, and organizers to present the information in a manner that will reinforce learning. In simplifying the complexities of medical emergencies with visual aids, this book serves as a practical manual/handbook for the successful clinical management of emergencies we come across in daily life.
Badar M Zaheer
Preface to the First Edition
Emergency care, a staple of Western medicine, remains severely inadequate in many areas of the developing world. Every minute, thousands of people die from a lack of basic emergency services. Even in these resource-limited settings, many causes of injury and death can be prevented or treated with simple procedural skills and a knowledge of core priorities in critical care. The assessment and treatment of patients in many acute medical and trauma situations should be based on the ABCD (airway, breathing, circulation, and deformity) protocol. With 25 years of personal ER experience and updated guidelines in emergency care, I have written 101 Clinical Cases in Emergency Room for training the reader to efficiently address immediate life-threatening concerns so as not to waste valuable time in trying to reach a final diagnosis. This book can be easily understood by all healthcare providers and first-responders in an emergency setting, including physicians, nurses, technicians, assistants, and students.
This book includes 101 real-world emergency cases grouped into 21 chapters based on body systems and other relevant scenarios. Each case is accompanied by tables, charts, and simple illustrations to clarify the content and facilitate the learning process. “Clinical pearls and pitfalls” are provided to emphasize the importance of “cannot-miss” diagnoses and the legal consequences of failing to identify these conditions. I also mention a few relevant historical cases that make the subject interesting and more memorable. Standard guidelines of treatment are stressed, and fundamental concepts in emergency medicine (e.g. the golden hour of opportunity in stroke and MI management) are discussed to optimize patient care and quality-of-life. I have included a chapter on preventable injuries like drownings and burns from fires, chemicals, and electrical sources. The last chapter deals with disaster management, triaging techniques, and the training of healthcare workers for efficient management of mass casualties. I also stress the importance of coordination between law enforcement and local communities for primary prevention of these disasters.
Each case study is designed to train readers to identify the acute issue and quickly formulate an appropriate treatment plan, especially in the setting of limited resources seen in developing nations. I hope this book is an enjoyable read compared to the average textbook, but at the same time a valuable resource for up-to-date information on the care of critically ill patients.
If I can save a single life with my educational points, the purpose of this book will be fulfilled.
Badar M Zaheer
Acknowledgments
Saving a life is like saving a nation, as commanded by our faith, and I am thankful to our Creator for giving me this opportunity to serve his creations.
First of all, I would like to thank my family for their support and encouragement throughout the process. My wife, Qudsia Zaheer MD and our children Fatima Zaheer MD, Zubair Zaheer DO, Naima Zaheer MS, and Zaki Zaheer MS (for his surprising help in preparing for board questions) as well as my mother Nurjehan for her prayers and blessings. Special note to Lisan Zahirsha as well.
To my professional mentors Judith E Tintinalli MD, author of Emergency Medicine Manual from University of North Carolina and Beatrice Hoffman from Johns Hopkins for their encouraging remarks.
To my teachers who have inspired me: First of all my elder brother Khutub M Uddin MD, my professional mentor Khaja Ahmed Shamsi MD, my primary school teacher Syed Sirajuddin, and my teachers from medical school, Late TP Gopinath MD and the late Prasad Rao MS who influenced me through their dedication and love for teaching medicine.
Special thanks to Amer Aldeen MD and Sh Zakaria Khudeira.
This book was only possible due to the continuous support of Jaypee Brothers Medical Publishers, New Delhi, India.